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January 22, 2022

Rapid At Home Covid Antigen Tests: Some Information

Rapid antigen home tests are useful to test yourself and/or family members for Covid-19.  These tests detect the presence of the Covid virus proteins not the virus RNA like PCR tests.  They detect virus from the nasal cavity in 15 minutes and correlate well with the period of virus transmission.  Every test comes with complete instructions how to perform the test - and it is important to follow the instructions exactly in order to get a valid result in 15-30 minutes..  There are at least a dozen products available, but during the omicron surge they may be hard to find.  Our government is now sending every HOUSEHOLD 4 free tests.  Order them online at covidtests.gov.

When is the best time to test? 

If you are exposed to a Covid+ person, test 2-3 days after the contact.  If negative test again daily or every other day until at least day 6.  If you are positive isolate immediately.  

If you have Covid symptoms, test, but if negative, repeat again the next day because there may not have been enough virus yet in your nasopharynx the first 24 hours.

If you want to test to make sure you are not infected before you are attending an event, or meeting with older or immune-deficient people, the best time to test is right before you go to the event.  You may be negative in the morning, but positive later in the same day.  The results with omicron can change quickly.  

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There are many sites with information about the Rapid At-Home Antigen tests.  This is a link to one that has information about using the tests and specific brands in case the tests may be hard to get. 

https://www.nytimes.com/wirecutter/reviews/at-home-covid-test-kits/

The tests that will be sent by the government are from iHealth- and they have very complete instructions with the test and on their website .  The test box in my collage has the iHealth box markings.

January 19, 2022

Upgrade Your Masks For Omicron

Help Upgrading Your Masks: Written by my Peds Oncologist Son Jason
 
These days, the most common questions I'm getting are about masks, so let's dig in! As you've now heard from me and others, if you've been relying on cloth masks, it's time to up your game; omicron demands a more robust defense. Your options are N95s, KN95s, and KF94s; let's break down the differences, but my short version is to get yourself a batch of well-fitting KN95s or KF94s.
• N95s are regulated by the CDC. There are *no* N95s with ear loops; the standard mandates head straps to ensure the fit of the masks, so most people find these more restrictive and harder to wear. Usually, these are the most expensive.
• KN95 are regulated by China. They can have ear loops, making them more comfortable but also meaning you have to pay a bit more attention to the fit. They're generally less expensive than N95s; there are a LOT of counterfeit ones on the market.
• KF94 are regulated by South Korea. They generally have ear loops, and have a slightly different shape that some people like more. They're also less expensive than N95s.
See Below for Jason's recommended sources of these masks: 

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I love Vida for both KN95 and KF94 masks; they have them for both adults and kids, you can choose a variety of quantities, and I've been impressed with their delivery speed. Project N95 is also a great resource for finding authentic masks. And finally, I'd avoid Amazon like the plague for masks — everything I read is that Amazon is doing a *terrible* job policing counterfeits.  

January 15, 2022

Omicron in Decline?

Here's Hoping! 

I follow the NY Covid-19 infection rates for the State, NY City, and Manhattan on the NY Forward Dashboard.  I was very happy to see the decline in the numbers this past week and decided to post some information from specific days in the two winter surges.

Last Year  1.4.2021       NYS  8.3%    NYC   6.9%        Manhattan   3.3%  Approx Peak

        1.15.2021    NYS  5.8% NYC  5.1% Manhattan   3.1%

        2.15,2021    NYS  5.0% NYC  5.5% Manhattan   3.9% 

                5.29.2021    NYS  0.6%     NYC   0.4%        Manhattan   0.3%  Approx Nadir

    

               10.15.2021   NYS  2.4% NYC  1.2% Manhattan   0.9%     Nadir Pre-Surge

        11.26.2021   NYS  4.7% NYC  2.2% Manhattan   2.1%     Omicron Announced      

12.27.2021   NYS  19.3%   NYC  19.6%       Manhattan   17.5%

 This Year 1.2.2022       NYS  23.4%  NYC   22.7% Manhattan    18.6%   Peak Numbers 

1.13.2022     NYS  16.3%  NYC   14.3% Manhattan    10.7%  

These numbers for the infection rate were posted by New York testing sites almost since the beginning of the pandemic and I followed them on a daily basis.  In late December 2021 the state was testing from 300,000 - 400,000 people per day - and an unknown number of patients were doing rapid tests at home. The surge in December and January were unprecedented. comparing the case numbers to the winter surge in 2020-21.  Each day I was shocked to see how fast the infection rate was rising.  On 12/25 the omicron variant was 85.4% and on Jan 1st it was 98%.  In the 1.12 graph I discussed it is clear that the rapid rise in cases in NYC was in the unvaccinated people.  The rapid DECREASE IN CASE NUMBERS now can give us hope that this infection rate will continue to plumet as in South Africa.     

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January 12, 2022

Infection Numbers in Fully Vaccinated vs Unvaccinated

Yesterday the New York Times had graphs for Covid-19 infections in New York City and Seattle, both cities had timely data for the rates of infection.  In NYC the graph shows the number of weekly cases per 100,000 from Nov 6th to Dec. 18th.  Infections in NYC by 12/25 were more than 85% omicron variant. The Y axis on the graph  is 0-3000 cases per 100,000 people.  Vaccination doesn't prevent "infection", but does block severe disease.  and this is also seen in hospitalizations and deaths in the graphs published in the NYT article for each..  The graphs for Seattle are also very similar - telling a consistent story.

The other two graphs for NYC also demonstrate a stark difference between the unvaccinated and fully vaccinated less than 1 month ago.

HOSPITALIZATIONS: Not fully vaccinated - 80 weekly per 100,000 people.  Less than 10 weekly per 100,000 people in the fully vaccinated.  Statistics from other studies show that many of these people (as many as 40%) are hospitalized with other diagnoses, but were positive for Covid-19 when tested.

DEATHS:  Not fully vaccinated - 4 weekly per 100,000 people.  Less than 1 in the fully vaccinated and the graphs show the big difference.  Deaths tend to lag 2-3 weeks after being infected, so the differences are expected to continue to rise. 

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January 8, 2022

Isolation vs Quarantine

The CDC has revised guidelines for Isolation and Quarantine in the face of the surge of omicron Covid infections throughout the country.   

You ISOLATE when you are sick and have been infected by the virus.  

You QUARANTINE when you may have been exposed to the virus and may or may not have been infected even if you do not have symptoms.  

CDC Guidelines for ISOLATION:  Stay home and isolate from people for at least 5 days.  The day you developed symptoms is day 0.  Wear a well fitting mask around others at home and in public on days 6-10 if you are afebrile and have decreasing or no symptoms.  You can take a rapid test at that time, but it is not required. In a British study 31% of patients still had a positive test on Day 5, and 1% on Day 10, but rapid tests are not reliable for determining when an individual is no longer contagious.. .

CDC Guidelines for QUARANTINE:

If you come into contact with someone with COVID-19, and you are fully vaccinated AND boosted, you don't have to quarantine. 

If you are vaccinated, but not boosted, or you have not been vaccinated, you should quarantine for 5 days, followed by strict mask use for 5 more days. The incubation period for the virus is usually 3-5 days, but may be as long as 10 days.  See Below  

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When I was a child I distinctly remember having measles and chickenpox - one year APART.  My doctor came to our house to make the diagnosis and then put a big sign on our front door that the house was in QUARANTINE - by an old public health definition.  After I was no longer febrile and symptomatic, my mother and I went to the Department of Health and turned in the Quarantine sign.  Both of those highly infectious viruses are now controlled by vaccines that children get early in life.  Please vaccinate your children and grandchildren against COVID-19.  More children are getting Covid and more are hospitalized.  

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